Counseling is a free service that is available to all actively enrolled students at Central Connecticut State University; and consists of an intake assessment, recommendations, individual counseling and outside referrals, as needed. The intake assessment will take place with one of our counselors, and will result in recommendations and follow-up instructions.

Please Note: Recommendations following the intake assessment may or may not include individual counseling at the Counseling and Wellness Center. If individual counseling is recommended, you will be assigned a counselor. Your assigned individual counselor may not necessarily be the same counselor completing your intake. Specific recommendations are based on information collected during the assessment process, as well as the availability of any/all appropriate services and supports.

Individual Sessions - Students who are scheduled for individual sessions are expected to arrive a few minutes before their scheduled appointment, as sessions begin on time. Individual sessions are 50 minutes long. The duration of counseling is based upon progress toward counseling goals.

Attendance Policy - It is expected that clients of the Counseling and Wellness Center will attend their scheduled appoints, on time. If it is necessary to reschedule an appointment, the Counseling and Wellness Center office (832-1945) must be notified as soon as possible (at least a 24 hours notice). Ongoing service is contingent upon adherence to the attendance policy. The Counseling and Wellness Center reserves the right to discontinue services if the attendance policy is not followed. If services are discontinued, we will be available to assist in making outside referrals, as needed.

Confidentiality - The Counseling and Wellness Center adheres to strict confidentiality guidelines. All student contacts/information will remain confidential, unless consent from the client/student is given to release specific information to a third party. Information may be shared within the Counseling and Wellness Center's clinical team during supervision. By law, confidentiality can only be broken by the counselor/Counseling and Wellness Center if the following conditions have been met: 1) The student is in imminent danger of harming themselves or someone else, 2) The counselor believes that a child (under 18 years old), or an elderly person (60 years or older) is being abused or neglected, or 3) A court/judge issues a subpoena where the counselor or Counseling and Wellness Center is ordered to release information.

Messages/Communication - Please call the main office (832-1945) if it is essential to contact a counselor outside of scheduled appointment times. Avoid using e-mail to communicate sensitive/confidential information, as e-mail is not a secure mode of communication.

Evaluation - At the completion of counseling, you will be asked to complete a voluntary Client Evaluation Form which will give you the opportunity to share invaluable feedback.

*I have read this informed consent and have been given the opportunity to ask questions.

Signed: __________________________________________

Date: ____________________________________________